Neuron chatter: Stigmatised and misunderstood, people with epilepsy find little help

In 2013, over 8,500 people were diagnosed with the highly manageable disease.

PESHAWAR: At least 8,685 patients from Khyber-Pakhtunkhwa were diagnosed with epilepsy last year. Mardan clocked the highest number of new patients at 2,122 according to a health department report.

The World Health Organization describes epilepsy as a chronic illness, characterised by recurrent seizures. Professors at Stanford University use the term “electrical storm” to explain what happens in an epileptic fit.

Simply put, too many brain cells or neurons become excited at the same time, causing the body to malfunction. Neurons pass electrical signals to other neurons. In normal circumstances, some of these signals would be inhibited by the receiving neuron, however, in patients with epilepsy, too many brain cells are excited at the same time, resulting in seizures.

The report issued by the K-P Department of Health’s District Health Information System (DHIS) covers the period from January to October 2013. After Mardan, Swabi recorded the second highest number of people suffering from epilepsy, 1,785. The provincial capital reported 217 new diagnoses in 2013.



Even though there are so many patients in need of treatment in the province, only Lady Reading Hospital (LRH) has an epilepsy facility, within their psychiatric ward. Khyber Teaching Hospital also caters to such patients, without the dedicated resources, in their psychiatric ward.

Talking to The Express Tribune LRH Senior Medical Officer Bakht Jehan Khan observed the number of epilepsy patients seemed to increase on a daily basis. He noted a 30-40% spike in the number of patients in 2013 as compared with 2012. LRH has an epilepsy outpatient clinic once a week where at least 20 to 25 patients visit from across the province.

Doctor vs shaman

Jehan explained epilepsy is a neurological disorder which involves repeated seizures. Episodes of disturbed brain function result in cognitive and behavioural manifestations.

The disease, he shared, is manageable. The right dosage and kind of medicines have been proven effective to control it in most cases. In other medical literature, different kinds of diets are also shown as an effective tool to manage the disease.

Dispelling common myths, Jehan noted many people assume the person undergoing seizures is having a “hysterical fit” or has been possessed by spirits from another realm. This, he noted, was not the case.

Because of prevailing misconceptions, Jehan explained, many epilepsy patients are taken to faith healers or treated with alternative medicine instead of being taken to medical specialists. These misguided efforts result in an intensification of the symptoms rather than them being easily managed through medication.

He declared 60% of the people in Pakistan never consult specialists at the earlier stage of this disease because of such notions and ignorance

Head injury, congenital abnormalities and chemical imbalances are some of the main causes of epilepsy and more than half the cases of epilepsy are idiopathic, he added.

While epilepsy has an impact on intellectual function and social adaptation, most studies find patients with epilepsy have regular cognitive function, depending on whether their epilepsy is idiopathic or a result of brain trauma.

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Epilepsy in Kyhber-Pakhtunkhwa
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Types of seizures

Seizures can be broadly categorised into three, which can then be further divided into more specific categories.

Generalised tonic clonic seizures come about when there is abnormal activity across the brain. It usually starts with rigidity in the limbs, followed by convulsions, unconsciousness and lasts for three or four minutes.

Absence seizures are more common in children, in which the patient blanks out for a few seconds before resuming activity.

Partial seizures are a result of abnormal activity in a limited part of the brain. Depending on which part the seizure can result in hallucinations, loss of memory, uncontrolled movements. A simple partial seizure is one in which the person preserves memory. A complex partial seizure is categorised by confusion, memory loss and some automated behaviour over which the person does not have control.

Within partial seizures, there are clonic seizures in which the person experiences repetitive, jerky movements. In Tonic seizures, the body goes rigid, experiencing muscle stiffness. A loss of muscle control is experienced in atonic seizures.

*Information has been taken from webmd.com, neurology.stanford.edu, and other health and medical websites.

Published in The Express Tribune, February 2^nd, 2014.